Pain is amazingly complex, and I must first give the disclaimer is that there is much we are still learning about pain. This post isn't about what we do know, it's about what we know and probably know, and how this conflicts with a popular mis-understandings about pain.
Myth: Damage In Your Body = Pain
Few things are clearer than this, pain does not come from nerves, or pain pathways; bain is a brain output, not an input. I repeat (because this is absolutely vitally important, if you get nothing else from this post, get this): pain is a brain output, not a brain input. Yes, there are neurological pathways that get activated when the body gets an ache, a sprain, a cut, but activation of these neurological pathways causes pain in some subjects, and no pain in others. This explains why one person is out of work for the afternoon with a papercut and the next may be coming into work with a broken leg. Pain is a vary individualized brain expression dependant on more factors than just the activation of some neurons.
A pioneer in these field is a man by the name of Melzack, and his research paper regarding what goes into expressing pain can be downloaded and read in full from HERE. His theories are summed up in the graphic below:
What's hopeful about more accurate description of pain is that is provides hope for those dealing with nasty, chronic pain that can't be pin pointed with any x-ray, MRI, or labwork. People who suffer with chronic pain hear this all the time, and it makes me furious: "Umm, you're MRI must be fine. It's probably all in your head."
This makes me want to slap someone. Of course it's all in your head! Everything is all in your head! The misconception is that because pain is sometimes expressed in the absence of anything visibly messed up on imaging or lab work (i.e. no tumor pushing on stuff, or no pinched nerve in the spine), that we can't do anything about it. WRONG. Look at the image above, how many other variables can we can we manipulate that feed into the nervous system, other than just rx'ing ibuprofen for inflammation? I'll give you a hint: try to label all the variables that are targeted with pharmaceuticals. OK, good. Now, how many variables does that leave untouched if we stop there. Answer: a lot.
The good news is that this myth is slowly being overturn by the masses of healthcare providers, but we still have a long way to go. I'll leave you with two great resources to delve into the subject of pain even further:
1) The guys who are basically at the forefront of this research have a website, go to that website here. Abso-friggin'-lutely jam packed with amazing research... for free.
2) An amazing book that is worth its weight in gold. Literally, reading and understanding pain may prove to be one of the most effective therapies in treating pain in the long run. Here is the book, if you struggle with chronic pain, dish out the cash and give it a read.
Here's to kickin' pain in the face.
I've been fond of the statement that movement is a necessary "nutrient" the human body absolutely requires to be able to express health. You can eat salads all day long, but you will not be as healthy as you should be if you're not moving.
New research that was published in this month of the British Medical Journal looked at the effect sitting had on life expectancy, and if they could get a number of years lost due to sitting. They did find this number.
The number they extrapolated was 2 years. TWO YEARS! If you want to extend your life two years, keep your daily sitting to less than 3 hours/day. I know, that's hard. Have you ever timed how much you sit in an average day? I'm aware of this fact, but between sitting here, writing this blog, typing up patient notes, sitting and taking histories of patients, and the ritual daily commute in my car (sitting, of course), I'm sitting WAY more than 3 hours per day... and it's killing me.
In another study done by researchers at Harvard, and published in The Lancet, it was estimated that sedentary living kills 1 in 10 people. A tithing of death given to those who use not the body they've been blessed with. (I'm being sarcastic, but a 10% effect is nothing to be joking about.)
To give us some perspective, let's compare sitting to something we're familiar with. You all know smokers, right? You probably ask yourself, How could they do that? They're killing themselves! You know they usually die earlier, you know they have heart problems more than others, and you can pick one out from a crowd by just the way they sound when they cough.
With all that said, I'm going to leave this computer now and walk around my office, maybe even do some push-ups in a hidden corner. Cheers!
... retract those blades, keep that joint in a secure position.
When benching, don't bench too much. And don't EVER bring your arm forward, if you feel your scapulae sliding sideways and forward, you're pushing too far forward.
It should look like this:
The picture on the right is correct, see those shoulders being pulled back.
Good luck making those pecs summer ready!
A neuron, the basic cell of your brain and nervous system, needs a few things to survive. One of the biggest things it needs is "activation." You see, your body is extremely efficient. That which you don't use, you lose. This is especially with nerves where, let's say, a particular neuron responsible for firing in a sequence that allows you spout off some spanish you learned for that attractive latina you had a crush on, may be fired repeatedly when you're chasing this lady; then abruptly halted after she turns you down. If we zoomed in on the neuron responsible for your spanish, we would see its connections diminish as you're no longer saying "que pasa" to the chica, and if your spanish isn't used for a very long time, that neuron responsible for your ability to speak spanish would be one of the many neurons that die every day. (If you're an adult, you've lost something like 6 neurons in the time it took you to read this first paragraph. Don't worry, you still have trillions left.)
A neuron that isn't being used will be lost. Your body is extremely resourceful, and if it sees something isn't being used, it shunts resources elsewhere.
How does this relate to your child? One of the ways neurons are activated and kept alive more than anything else is through bodily movement... through exercise! Is it any wonder why children are so full of life? They're stimulating and crafting their brains! They're doing what they were built to do. My spazz of an 11-month-old is the epitome of this: if he's awake, he's moving; if he can't move his body, he's moving his vocal chords. Nothing is still.
The best thing you can do for you kid – right up there with making sure they have enough omega-3 fatty acids – is giving them plentiful oppurtunities to move. Don't call it "exercise," because to a kid, it's fun. Just get out of the way and let them do their thing, and their brains will flourish.
"The mental apparatus of the coming generation is developed in [the womb] and the time to begin supplementation is before conception. A normal brain cannot be made without adequate supply of omega-3 fatty acids, and there may be no later oppurtunity to repair the effects of an omega-3 fatty acid deficiency once the nervous system is formed." (bold added) - Wiliam E Connor; Oregon Health Sciences Center
When I study health and wellness issues that affect my kiddos, what usually scares me are things called developmental windows — times in a growing kid's life were if certain things occur or don't occur, they have lasting results that are difficult or impossible to repair. Its scary to think that I may have missed something. You didn't provide your kid with this or that nutrient, you let your child watch television before they turned two, they are therefore doomed for the rest of their life! — is pretty scary.
What about your kid's brain? Is that something you want to set up for success? That is, after all, the organ through which your child will experience existence. It is the organ through which your child will be able to be happy, learn, experience life, and make his/her mark on the world. The brain is pretty much square one for your child.
Your kid's brain is made of fat, and approximately 30 years prior, scientists started discovering that it takes a certain kind of fat to make a brain right. This was partly discovered by accident when children raised on formula (which were little more than skim milk and sugar) instead of breastmilk were having serious developmental delays — literally being retarded in their brain growth.
Why all of these brain problems?
Around 80 years before that a food processing technique began taking out certain kinds of oils in foods and saw that shelf life of foods increased dramatically. Without these oils, food could stay on the racks for weeks, not days or hours. This was great news! More people could be fed. Food poisoning would decrease.
...Or was it?
Years later it turns out that those fats and oils that were removed from foods were also the same fats that coated nerves and made brains.
PART TWO COMING TOMORROW
Read this jazz. Do it.
Ever feel foggy? I do. I hate it. I hate forgetting a name, or how to spell "the." Stuff like that is crazy, but it happens all the time. What can you do about it?
Special pills? Special book? Sudoku?
Honestly, the number one thing you can do for your brain is to move. MOVE GOSHDARNITTOHECK! Like one genius says, "motion is lotion for the brain." Want a smooth, silky brain that can calculate tax before the assistant rings you up on the register? Want to be able to actually remember where that article was last week that supported your recent political stance? Want to remember your grand kids?
Take fish oils, but realize that brain atrophy will not be halted by nutrition alone. Nutrition is the raw substance; exercise causes the actual brain building to occur. The brain is literally there for you to move. Did you notice what they said in the conclusion from that study?
As predicted, no signiﬁcant changes in either gray or white matter volume were detected for our younger participants. However, when directly comparing the changes in gray matter volume for older exercise and control participants, we found that the previously sedentary aerobic exercising group showed a beneﬁt in brain volume in several regions after participation in an exercise training protocol. (bold added)
Want your brain to stop shrinking as you lose thousands of neurons per day? Move.
There is no pill, potion, or lotion that can mimic the effects of exercise for you. Don't wait for one.
There were outbursts from parents, they wanted blood! You've made little Johnny a 120 pound 7 year old! How dare you! Where is the respect?! You're killing our children! They said. Coca-cola and corn syrup were the bad guy. So, some schools made vending machines illegal in schools. Cool.
But parents have been duped, meth has only been replaced with speed. Thank you Coca-cola, you've taken out the sody pop and replaced it with healthy orange juice.
Remember this: when it comes to your pancreas, and obesity, and diabetes, and brain changes, there is little to no difference between juice and coca-cola.
Hippie parents are always shocked when I tell them that that organic, "fresh-squeezed" orange juice in the bottle they just gave their 9 month old is no different than the Pepsi they saw an "uneducated" mom put into her baby's bottle at Wal-Mart.
You've been duped. There is no difference. Each is a massive amount of sugar dumped into an incredibly small body.
Go back a couple thousand years. Imagine that you have to forage and hunt for your food. Do you have any idea how hard it would be, how many calories you would have to expend, to gather enough fruit to make something as sweet as our modern day fruit drinks/colas? Sweet is an uncommon reward in nature, but we've made it an everyday occurrence. Liquid candy is not natural.
What Can You Do If Your Kid Is Hooked
If your kid has been "used to the juice" then there's going to be some symptoms of withdrawal. We're made to crave sweet and salty. Start by diluting your juice with water. Then, just give water. After your child's taste buds re-adapt they will be able to appreciate the quench that comes with water, and even appreciate the subtle taste good water has.
Smoothies: The Exception
The drink that is acceptable and totally different from juice is a smoothy. Why? Fiber. In smoothies, entire veggies and fruits are bashed to death, and the fiber remains (in juices fiber is extracted) to act as a slow release for the sugar and keeps insulin from shooting up like a rocket.
Don't believe the commercials. Drink juice every now and then, but just don't buy the hype that store-bought juice is "healthy."
Much sugary love,
"Why does it do that?" is a question I often get when one of our athletes comes up with a back spasm. "Why are my hamstrings so tight?" "Why does it always pull in my calf?" "Why does my lower back hurt, I'm young, and strong?"
These are questions I've thought of myself, and I always get similar answers: Yes, you're an athlete, and you're in "good shape" by most standards. You come to practice and practice your heart out for two hours, five days a week. But let's break down the rest of your day:
8am - 3:00 pm Sitting. At school.
5:30 - 10:00 pm Probably sitting, watching TV, working on homework.
Then, the line I repeat almost every day as I work with patients at our clinic: Improper sitting destroys the spine.
For that reason, I blame many of the physical abnormalities I see in our young based on the environment their forced into during school. Yes, children should be able to pay attention to a teacher for hours. I'm serious, the ability and art of focus should be taught and practiced day in and day out. What I'm against is the constant, chronic sitting, slouching, slooping forward. We're destroying spines and bodies, and as a result, we're destroying minds. What the body does, the mind follows.
Parents, read this book:
I'll give you the low down on what happens. Ratey, MD, a psychologist and professor at Harvard Medical School, chronicles what happens to children's brains as exercise was introduced religiously into a highschool in Chicago, Naperville Central High School
"...latest in a long line of educational experiments conducted by a group of maverick physical education teachers who have turned the nineteen thousand students in Naperville District 203 into the fittest in the nation — and also some of the smartest.
"It’s no coincidence that, academically, the district consistently ranks among the state’s top ten, even though the amount of money it spends on each pupil — considered by educators to be a clear predictor of success — is notably lower than other top-tier Illinois public schools... Its per-pupil operating expense in 2005 was $8,939 versus $15,403 at Evanston’s New Trier High School. New Trier kids scored on average two points higher on their ACT college entrance exams (26.8)"
Ratey, John J. (2008-01-10). Spark: The Revolutionary New Science of Exercise and the Brain (p. 13). Hachette Book Group. Kindle Edition.
What is it that this school is doing so differently? A zero hour PE class where students are graded on individual physical performance metrics — e.g. you must keep your heart rate up to a certain amount during an entire mile. Then, after zero hour PE, kids take their toughest academic assignments. Have a tough test? You take it then.
Not only that, but chairs are replaced with exercise balls, treadmills, and stationary bikes. Got a ADHD-like kid that can't sit still? Try making his legs pump a stationary bike when you give him a lecture and notice the difference.
These are all changes that could be done in Farmington, and I think it would help our kids be all around healthier. If you read that book, one of the most frightening things is how dependent brain growth is on physical activity; this is scary because of how little activity our children get in school. Remember, the track athletes I work with are they by choice. Athleticism is an "elective," by most school standards.
But is it?
First off, please get the new understanding that pain is not simply a brain input; pain is brain output. And there's a difference. This is a deep discussion that we can have, but I'd rather refer you to someone who did a great piece on this (DOCUMENT).
How can food relate to this?
Inflammation is the process that happens when you sprain an ankle. There is a chemical cascade that is set off around and at the damaged tissue, and the end result is redness, swelling, and — you guessed it! — pain.
But, what if I told you that what you eat, your chemical composition, lends itself to someone who is easily inflamed, or someone who is not. (The opposite of inflammation is rest, calm, non-irritated.)
The truth is, you can. This is the secondary link with food intake and pain.
Two Pathways: One is More Painful
Ever wondered how a non-steriodal-anti-inflammatory works? It works by shutting off an enzyme called "COX." NSAID's are called COX-inhibitors. Please look at this picture.
At the top, on the left, is omega 3 fatty acids. On the right is omega 6 fatty acids. You've probably heard a lot of buzz about "taking your omegas," this is one reason why. Your body is made of up tons of fats. In fact, most of the outside lining of cells is made up of this fat. Omega 3's have a tendency to be anti-inflammatory. Omega 6's have a tendency to be inflammatory. Why is this important? Because your body needs a balance of the two. Not too much, not too little.
It has been estimated that the human body is supposed to have a ratio around 1:1 of omega 6's to omega 3's. Most humans nowadays have a ratio closer to 15 - 20: 1. Not 1:1. That tilts the scale heavily in the direction of omega 6 saturation. That means that your cells are made out of the PRO-inflammatory molecules, which means that they are naturally more likely to get inflammed, irritated, and lead to "pain output."
One of the chief fatty acid scientist, William Lands, was frequently hired on as a consultant to pharmaceutical companies who were then just beginning to make the ibuprofens and Aleves that we are so familiar with today.
"...you can change the kind of [inflammation] signaling in your body by changing the kinds of fats that you eat.
... He [Lands] always told the companies that nutrition would regulate the availability of prostaglandins [molecules that signal inflammation] too. And their answer was always the same: There's no way to make money on nutrition. Lands said the same thing about nutrition to john Vane when he met this very famous pharmacologist on a trip to Vienna. "Yes," he remembers Vane replying, "but you can't patent that [nutrition]."" - Queen of Fats. (2006) Susan Allport. pp. 99-100
This same truth is available to you now. Want to stop popping an aspirin every morning before heading to work? Try limiting the inflammatory foods you eat, those foods rich in omega-6 fatty acids. Here is a list (LINK). Then, add an omega-3 supplement to your diet while increasing your food intake of omega-3's (usually fish, sardines being one of the best — I know they smell nasty... think of it like medicine), and see the change in pain.
"Stop whining, it's all in your head."
Maybe your mom told you that when you were being a little... bratty. Maybe later on in life you had some really tough challenges that you couldn't get over, or that people couldn't explain, so they told you "it's all in your head."
Have you ever thought about the absurdity of what people mean when they say this statement?
First, it is all in your head. Everything is in your head. Everything is processed and experienced in that mushy pink stuff resting between your ears. But when people say "it's all in your head" it's supposed to somehow make what is happening to you less real in some way. That makes no sense. They'll say, "It's all subjective, we need some objective stuff to go on." How is that possible when it comes to your head? It filters and skews everything.
Second, people dampen it down when it is in your head. "It's just placebo," they'll say, when you get a crazy result from something they don't understand. Well... so? I had a great friend who once told me "I'm willing to pay for placebo." He wasn't be facetious, he was telling the truth. He recognized placebo as a power we should exploit, not something we should right off. We should realize that all obstacles must first be overcome in the mind if they are going to be overcome in "reality" (I put quotation marks in that for a reason).
Instead of getting downtrodden when someone says "it's all in your head," thank them instead. They're pointing out an important fact of life. And once you realize that "it's all in your head" you become not so helpless afterall.
Josh holds a Doctor of Chiropractic from Parker College of Chiropractic, is currently enrolled in The Carrick Institute studying Functional Neurology, and runs a full-time practice in Farmington, NM. His interests are in neurology of movement, pain, and what a human being needs to express health. He also likes to read and write, hence this blog.